• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Epoetin J0885

Create Wiki
K

kendalb

Guest
Messages
23
Location
Newberry, SC
Best answers
0
We are seeing denials for Epoetin J0885 when we dose above 60,000 units. I cannot find any information, and I have searched relentlessly, on why we are paid for 60 but not 80. Have any of you seen this or have any
recommendations for proving medical necessity proactively rather than in response to a denial?
 
Surgery

• A patient is taken to surgery for I&D and wound vac placement. Once the patient has undergone anesthesia and in the OR room, the doc determines the wound has healed more than expected since the prior visit and only swabs the wound for a culture.
1. Can you charge for the I&D and append a modifier? If so which modifier?
2. If you can’t charge the procedure, how do we bill for other services leading up to a procedure that wasn’t completed? Won’t MCR deny all other charges without and actual surgery to associate those charges to?
 
You must log in or register to reply here.
Top